Research on referral preferences of clinical doctors in public hospitals based on discrete choice experiment
10.3760/cma.j.cn111325-2024-0229-00138
- VernacularTitle:基于离散选择实验的公立医院临床医生转诊偏好研究
- Author:
Hao YU
1
;
Hui LYU
;
Hui JIANG
;
Jingjing WANG
Author Information
1. 新乡医学院健康中原研究院，新乡 453000
- Keywords:
Referral and consultation;
Hospitals, public;
Referral decision;
Preference;
Discrete choice experiment
- From:
Chinese Journal of Hospital Administration
2024;40(4):248-253
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigated the referral preferences of clinical doctors with prescription authority in public hospitals, and to explore the factors influencing clinical doctors′ referral decisions.Methods:A questionnaire based on discrete choice experiments was designed to investigate clinical doctors′ preferences for patient referral. A multi-stage stratified random sampling method was employed, targeting 499 clinical doctors from 25 public hospitals in Henan Province. The on-site questionnaire survey was conducted between February and March 2023. Conditional logistic regression analysis, based on parameter estimation from Cox proportional hazards models, was used to explore clinical doctors′ preferences for patient referral concerning patient condition, hospital capability to manage the patient, patient′s willingness for referral, completion of surgery or major treatment, and hospital or medical insurance policy support for referral preferences.Results:A total of 439 valid questionnaires were collected. Doctors showed a preference for referring patients with fluctuating acute and critical conditions ( β=0.81, P<0.05), patients with high risk or with moderate risk but manageable overall ( β=0.75, β=0.60, P<0.05), patients clearly expressing a desire for referral ( β=0.41, P<0.05), patients with incomplete surgery or major treatment ( β=0.66, P<0.05), and patients supported by hospital or medical insurance policies ( β=0.16, P<0.05).Conversely, doctors were reluctant to refer patients with unclear attitudes towards referral ( β=-0.93, P<0.05) or unclear hospital or medical insurance policy support ( β=-0.23, P<0.05). Conclusions:Patient condition, hospital capability to manage the patient, completion of surgery or major treatment, and patient willingness significantly influence doctors′ preferences for patient referral. Hospital support for patient referral has a minor impact on doctors′ referral preferences.
